宫腔粘连分离术后复发为重度宫腔粘连的因素分析

发布时间：2018-01-25 02:18

本文关键词： 宫腔粘连分离术宫腔粘连危险因素分析　出处：《实用妇产科杂志》2017年10期 　论文类型：期刊论文

【摘要】：目的:探讨宫腔粘连(IUA)分离术后再次发生IUA且成重度粘连的危险因素。方法:前瞻性建立IUA复发患者的临床队列,根据美国生殖学会IUA评分标准分为非重度组和重度组,首先逐一分析可能相关的因素,然后对有统计学意义的因素进行多因素非条件Logistic回归分析。结果:2015年1月至2016年6月共295例复发性IUA患者参加研究。多因素分析发现初次发现IUA时为重度、刮宫后闭经史、多次IUA分离手术史者复发成重度粘连的风险明显增高,其OR值分别为12.12(95%CI 5.30~27.7),3.24(95%CI 1.60~6.57),1.69(95%CI 1.11~2.58)。结论:初次发现IUA时为重度或有刮宫后闭经史的患者行IUA分离手术后易复发为重度粘连;多次IUA分离也是IUA复发并成重度粘连的危险因素。
[Abstract]:Objective: to investigate the risk factors of recurrence of IUA and severe adhesion after intrauterine adhesion (IUAA) separation. Methods: the clinical cohort of patients with recurrent IUA was established prospectively. According to the American Society of Reproduction (IUA) score, it was divided into non-severe group and severe group. First, the possible related factors were analyzed one by one. Then the factors with statistical significance were analyzed by multivariate unconditioned Logistic regression analysis. Results:. From January 2015 to June 2016, a total of 295 patients with recurrent IUA participated in the study. Multivariate analysis showed that the first time IUA was found was severe. After curettage, the risk of recurrence to severe adhesion in patients with multiple IUA separations was significantly higher, with OR values of 12.12 ~ 95 CI 5.30 ~ 27.7). 3.24 / 95 / CI 1.60 / 6.57). Conclusion: the patients with IUA at the first time were severe or had a history of curettage amenorrhea. The patients who had undergone IUA separation were prone to relapse into severe adhesions. Multiple IUA separation is also a risk factor for recurrence and severe adhesion of IUA.
【作者单位】：南京医科大学附属鼓楼临床医学院;南京大学医学院附属鼓楼医院;
【基金】：中国科学院“干细胞与再生医学研究”战略性先导科技专项(编号:XDA01030505) 江苏省重点研发计划(社会发展)项目(编号:BE2016612)
【分类号】：R713.4
【正文快照】： 宫腔粘连(intrauterine adhesion,IUA)又称为Ash-erman综合征,是损伤或炎症引起的子宫内膜基底层严重受损导致内膜功能层部分或完全缺失,子宫内壁之间由纤维桥连接,引起宫腔部分甚至完全闭塞[1],临床表现为月经量减少甚至闭经、不孕、反复流产等[2]。据统计,IUA在不孕症中的发

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